Colchicine is a very old drug and is made from the Autumn Crocus, Colchicum autumnale (a poisonous European flowering plant). It has been primarily used in the treatment of gout. Although it is not formally indicated or approved for the treatment of dermatological diseases, colchicine has been prescribed for some skin conditions with good results. Its effectiveness is due to several immunological and anti-inflammatory properties.
In New Zealand colchicine is available as 0.5mg tablets (previously 0.6mg).
Colchicine for dermatological diseases
Colchicine in varying dosages is used for a number of dermatological diseases. Its effectiveness has only been shown through the treatment of small and mostly uncontrolled study groups.
|Recurrent aphthous ulcers||1.5-1.8mg/day||
More controlled and double-blind studies are needed to prove the usefulness of colchicine in dermatological diseases.
Colchicine should not be used under the following circumstances:
- Patients with a known hypersensitivity (allergy) to the medicine
- Patients with serious gastrointestinal, kidney, liver or heart disorders
- Patients with blood diseases in which there are low numbers of white cells or platelets
Colchicine can be fatal in overdose. Treatment with colchicine should be stopped immediately when abdominal pain, diarrhoea, nausea or vomiting occur. These are the first signs of toxicity and usually occur between 0-24 hours after taking the medicine.
The most common side effects are abdominal pain, diarrhoea, nausea or vomiting, which occur in up to 80% of patients receiving a maximal dose. Gastrointestinal symptoms are worse at higher dosages. These symptoms are a good indication that toxicity is approaching and the medicine should be stopped.
Other side effects include:
- Bone marrow depression resulting in agranulocytosis (absent white blood cells) and thrombocytopaenia (low numbers of platelets)
- Peripheral neuritis (nerve inflammation affecting hands and feet)
- Purpura (bleeding into the skin)
- Myopathy (weak muscles)
- Loss of hair
- Azoospermia (absent sperm production).
Colchicine, when used in low doses, has a low rate of side effects. Beneficial effects without the side effects is possible by reducing the dosage.
- Book: Textbook of Dermatology. Ed Rook A, Wilkinson DS, Ebling FJB, Champion RH, Burton JL. Fourth edition. Blackwell Scientific Publications.
- Sullivan TP, King LE, Boyd AS. Colchicine in dermatology. Journal of the American Academy of Dermatology 1998;39: 993-9. Medline.
On DermNet NZ:
- Medicaction Alert 8 Colchicine June 2009 – Safe and Quality Use of Medicines, DHBNZ New Zealand
- Consumer medicine information – Medsafe
- Medicine data sheets – Medsafe
- Drugs, Herbs and Supplements – MedlinePlus
- Colchicine: Lower doses for greater safety: Medsafe
Books about skin diseases:
See the DermNet NZ bookstore